Physician’s oath to humanity

Hippocrates is often regarded as the father of modern medicine in spite of his mistaken belief that illness and health were determined by the ups and downs of the four “humours,” namely black bile, yellow bile, phlegm and blood. If the humours were in harmony, the individual would be healthy, if they were out of kilter, illness would ensue. In light of what we now know about the workings of the body, this theory makes no sense, but it was revolutionary in the sense that it related sickness to what we could loosely call problems with the body’s chemistry. Prior to Hippocrates the common belief was that illness was the result of retribution from deities for human misdeeds or that it was the work of mischevious spirits. But Hippocrates did more than just orient physicians away from mythology towards observation and documentation of symptoms. Back in the fifth century B.C. he gave us the Hippocratic Oath which many medical students still take. The essential features of the oath include a promise to give no drug nor perform an operation for criminal purpose even if solicited, to maintain patient confidentiality, to guard against corruption, and to practice the art of medicine in uprightness and honour. It is one thing to pay lip service to such a oath and another to abide by it.

During the Third Reich, Nazi doctors conducted unfathomable medical experiments on both Jews and non-Jews. But the Nazis were not the only ones. The Japanese were also notorious for medical experimentation on prisoners that resulted in disfigurement, disabilities, torture and death. American doctors took part in their share of unethical experiments as well. The Tuskegee syphilis experiment was an infamous clinical study by the U.S. Public Health Service beginning in 1932 designed to study the natural progression of untreated syphilis in rural African American men. The men were not told they had syphilis and were not treated for the disease even when penicillin became available and was shown to be effective. In 1948 the shock of such extreme human rights violations led to an attempt to update and expand the Hippocratic Oath in the form of the Declaration of Geneva. This underlined the importance of doctors extending their duties beyond administering to the sick to improving the general welfare of humanity. Most importantly, the Declaration asks doctors to swear that they will not permit considerations of religion, nationality, race, party politics or social standing to intervene in their practice. They also promise to give their teachers the respect and gratitude they are due. Most physicians today do abide by ethical standards, not because they have sworn an oath but because they have the right character. The selection process for medical school is very rigorous and is designed to filter out individuals with questionable ethics. The process works well, but is not foolproof. The same way that there are ethical plumbers and unethical ones, ethical electricians and unethical ones, ethical mechanics and unethical ones, there are ethical physicians and a few unethical ones. They sell worthless supplements to their patients, steer them away from effective therapies with promises of “natural” wonder drugs and promote ridiculous detox treatments. Hippocrates would not approve.